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  • ID
    #17808963
  • Job type
    Permanent
  • Salary
    TBD
  • Source
    Amerihealth
  • Date
    2021-08-01
  • Deadline
    2021-09-30
 
Permanent

Vacancy expired!

Job Brief Supports corporate, plan-level, and depart. strategies and goals for HEDIS process external data feeds to optimize HEDIS performance.

Your career starts now. We're looking for the next generation of health care leaders. At AmeriHealth Caritas, we're passionate about helping people get care, stay well and build healthy communities. As one of the nation's leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, we'd like to hear from you. Headquartered in Philadelphia, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. Discover more about us at www.amerihealthcaritas.com.

Responsibilities: Supports corporate, plan-level, and departmental strategies and goals for HEDIS process. Meets this standard by effectively applying both business knowledge and technical expertise to support business initiatives and solve business problems.

Essential Functions include but not limited to:
  • Supports corporate, plan-level, and departmental strategies and goals for HEDIS process external data feeds to optimize HEDIS performance.
  • Meets this standard by effectively applying both business knowledge and technical expertise to support business initiatives and solve business problems.
  • Generates and maintains thorough and accurate documentation related to data, databases, business rules, and reporting policies and procedures for all LOBs.
  • Develops and executes test processes related to end-user data and databases; documents and tracks data-related issues, and facilitates resolution of such issues.
  • Performs analysis of clinical data.
  • Develops reports to provide information to stakeholders (Use of SQL, SAS, Tableau)
  • Assists with data transformation / standardization activities.
  • Works closely with the data warehouse team and others within IS to ensure timely and complete receipt of data from all sources.
  • Assesses data within the database for completeness and accuracy.
  • In collaboration with IS, tracks file format changes and other template variance. Communicates with data source contact when issues arise.
  • Supports efforts to onboard new data feeds and assists with evaluation of new feeds including identification of prioritization
  • Participates in investigation of HEDIS variance related to clinical data exchanges including analyses and plan-initiated requests
  • Actively collaborates with the HEDIS team on longitudinal projects
  • Works to support team and organizational goals.
  • Assures the ongoing high performance level of the overall department through continued knowledge acquisition and knowledge sharing with co-workers

Education/Experience:
  • Bachelor's Degree.
  • Required - preferably with a concentration in health care related field, statistics, Information Technology, or mathematics.
  • Minimum 1 year HEDIS experience required, 2+ years preferred.
  • Minimum 5 years of work experience in healthcare and/or managed care.
  • Familiar with standard relational database concepts.
  • Strong skills in at least one database query language (SAS, SQL, Tableau, and/or Python).
  • Familiar with clinical ontologies and code sets: SNOMED, LOINC, ICD, etc. is a plus.
  • Background in use of statistical process control techniques, data modeling, and/or data analysis.
  • Familiarity with HEDIS technical specifications.
  • Familiarity with National Interoperability and Clinical Data Exchange standards including HL7 standards and healthcare related EDI technologies.
  • Alignment with the AmeriHealth Caritas mission of helping people get care, stay well and build healthy communities with a special concern for those who are poor.

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